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Bcbs timely filing limit for secondary claims professional#

The rejection verbiage may differ depending on the trading partner.Īs a reminder, you should always check CareFirst Direct or CareFirst on Call for claim status before submitting a secondary claim. View the chart for additional information on the front-end rejections. 53819 - Provider must accept assignment to send Medicare Crossover electronically.53817 - Invalid Primary Payer Information.53816 - Adjustment cannot be sent electronically.53815 or 53818 - Missing Primary Payer payment information.

View the 837 Companion Guide for details.Ĭlaims received without the required information will be returned at the front-end with one of the following messages: If a paper claim is submitted, it must be accompanied by a copy of the Medicare EOB.Įlectronic claims will need to contain specific information in the 837 claims transaction set.

Bcbs timely filing limit for secondary claims professional#

These claims are not impacted by the 30 day requirement and do not require the inclusion of a Medicare EOB.Īll professional and institutional providers should submit Medicare Secondary claims electronically.

Medicare claims billed using a 'GY' modifier can be submitted directly to CareFirst without prior submission to Medicare.

When you receive a rejection notification, you must resubmit these claims to CareFirst for processing through BlueCard ®.

Out-of-area member claims for covered services are now rejected by the member's home plan.

If you are submitting a secondary claim electronically (professional providers only), you must include the Medicare EOB or remittance advice date.

Wait 30 days from the Medicare Explanation of Benefits (EOB) date before submitting your secondary claim.

Effective October 2013, the Blue Cross Blue Shield Association (BCBSA) implemented new regulations governing the submission process of Medicare Secondary claims.